They See the Flip Side of Holiday Cheer Inside the Emergency Room

The paramedics stride past the Christmas tree into the emergency room, wheeling in a man whose head is swathed in blood-soaked gauze.

“T.C.,” one paramedic briskly reports to a doctor--shorthand for “traffic collision.” Driving along a Torrance street Saturday night, the man apparently smashed into a parked car, ripping a deep gash in his forehead. Police would cite him for driving under the influence of alcohol.

As thousands spend the evening shopping, wrapping presents and reveling at holiday parties, the staff in the Little Company of Mary Hospital emergency department--one of the busiest in the South Bay--is hard at work, dabbing away blood and mending torn flesh.

This is the other side of the holiday season, a darker side that emergency medical workers know all too well. They report that the holidays can produce a surge of emergency room cases ranging from heart attacks to kitchen injuries.

“We see all the bad things,” said emergency physician Dr. Kent Shoji, associate director of the Little Company of Mary emergency department in Torrance. “We see the sick people. We see the deaths. We see the rapes, the overdoses.”

Before the holidays end, the Little Company of Mary emergency staff expects to see more “T.C.” victims like the man with the bloody forehead who lies on a hospital gurney six days before Christmas, eyes closed and barely conscious.

Dr. Paul C. Randau stands over the man, methodically stitching his cut, which is so long and deep that it takes three layers of sutures and an hour to close. Registered nurse Pam Everroad rinses blood from the man’s hair, and the doctor begins suturing a second, smaller cut.

Abruptly, the room echoes with the cries of babies. Three infants have arrived with flu-like symptoms.

“In the movies, the doctors spend all their time with one patient,” said Randau, a 15-year veteran of the Little Company emergency department. “But Dr. Marcus Welby is not in the emergency room.”

Instead, emergency medicine requires moving rapidly from one case to the next--especially during the holidays, when the patient load grows. Said Randau: “You have to be totally relaxed, but focused all the time.”

Although the ebb and flow of patients is unpredictable, certain patterns emerge around the holidays, some medical workers said.

Christmas Day is often quiet. But later, the pace usually quickens.

“Christmas night gets bad, because everyone has experienced their Christmas. They’ve eaten too much. They’ve drunk too much,” said Dr. Alan Heilpern, medical director of emergency services at California Medical Center in Los Angeles.

Some emergency workers believe the period between Christmas and New Year’s brings the heaviest traffic of the year. Hospital statistics suggest they may be right.

The Little Company emergency room treated 2,873 people in December, 1991, a 23% increase over its monthly average and its highest volume for the year. Torrance Memorial Medical Center had a 17% increase in emergency patients that same month, while emergency traffic was up 10% at South Bay Hospital in Redondo Beach.

At busy Harbor-UCLA Medical Center, the county hospital serving the South Bay from just east of Torrance, any holiday surge is hard to measure “because of the sheer volume of patients,” said Dr. Robert Hockberger, chairman of the center’s Department of Emergency Medicine. Harbor-UCLA’s emergency room treated 112,000 last year.

A multitude of forces combine at Christmastime to bring patients to the emergency room, hospital officials say.

More traffic accidents can occur as people rush to complete their Christmas shopping, drive home from late-night parties or travel out of town for family reunions.

The generous flow of alcohol during the holidays--from rum-filled eggnog at Christmas parties to New Year’s champagne--can increase the potential for traffic accidents.

Local emergency room workers report a holiday increase in drug overdoses, which they blame on depression and the pressures Christmas can produce. Little Company of Mary treated three overdose victims in a single day last week.

The Norman Rockwell images of happy families that prevail during Christmas can accentuate people’s unhappiness with their own lives, hospital workers say. “We see people who come in who are just very depressed,” said Dr. Gerry Reich, medical director of the Torrance Memorial emergency department.

Buffeted by holiday pressures, some people suffer anxiety-related heart palpitations, chest pain or hyperventilation. Others choose to “take a vacation” from their low-fat or salt-free diets, deciding that “it’s Christmas, for heaven’s sake, and I’m going to go and have a big turkey meal,” said Dr. Jerome R. Hoffman, professor of emergency medicine at UCLA.

That can aggravate longstanding medical problems, sending them from the Christmas table to the emergency room gurney.

Meanwhile, increased alcohol consumption often translates into more fights and other violence. Shoji at Little Company reports that more sexual assaults occur during the holiday season.

Further complicating matters, the holidays come at the onset of colder weather, sprinkling emergency rooms with victims of flu, colds or pneumonia. Some arrive at the hospital after discovering that their own physicians are on vacation; others fall ill while visiting relatives in the South Bay.

Then there are the basic household accidents: cutting a finger with a turkey carving knife, toppling from a ladder while hanging ornaments on the tree. One Torrance Memorial employee, Anne Laity, was hanging holiday greenery in her dining room when she fell from a ladder three weeks ago. She was treated in the hospital emergency room for a fractured vertebra and received nine stitches in the back of her head.

Even the season’s good Samaritans find themselves seeking medical help.

Salvation Army Capt. Sheila Bradley waited at the Torrance Memorial emergency room Friday as a colleague--who was supposed to be bell-ringing that day at a Palos Verdes Peninsula supermarket--was treated for an irregular heartbeat.

Most people get a holiday respite from work, but emergency-room employees often do not.

Patients “keep coming in, so we keep having to go to work,” said Joanne Gowins-Rubin, president of the California Emergency Nurses Assn.

They may not even have time to go to the hospital Christmas party.

“We just had a party the other day, and it was, ‘Who’s going to run down the hall and get 10 pieces of cake?’ ” said registered nurse Kim Colonnelli, director of emergency services at Daniel Freeman Memorial. “It’s not like an office where you can close up at 3 p.m.”